Instructions After Tooth Extraction

Proper care after a tooth extraction is important for healing. Some bleeding, soreness, and swelling are expected after surgery. These instructions apply whether you have had a single tooth or multiple teeth removed. Additional instructions for patients having multiple extractions or an immediate denture are included below.

Bleeding

Some bleeding or blood-tinged saliva is normal after a tooth extraction. A blood clot will form in the extraction site and is an important part of the healing process.

Keep the gauze placed over the surgical area in position with firm pressure for approximately 30 minutes. If bleeding or oozing continues, replace it with fresh gauze and bite with firm, continuous pressure for another 30 minutes. Repeat if necessary.

A moistened tea bag may also be placed over the extraction site and held with firm pressure if bleeding continues.

Avoid vigorous rinsing, spitting, using straws, or touching the extraction site on the day of surgery. These activities may disturb the blood clot and cause additional bleeding.

If bleeding remains heavy or your mouth is rapidly filling with blood despite firm pressure, please call our office for further instructions.

Swelling

Some swelling is normal after a tooth extraction, particularly following a surgical extraction or the removal of multiple teeth.

Apply an ice pack to the cheek near the surgical area for approximately 20 minutes on and 20 minutes off, as often as comfortable, during the first 24 to 36 hours.

Swelling may increase during the first few days before beginning to improve. After the first few days, moist heat may be helpful if swelling or jaw stiffness persists.

Pain

Some discomfort is normal following tooth extraction. If you are able to take nonsteroidal anti-inflammatory drugs (NSAIDs), good options include one of the following:

Aleve (naproxen): 1-2 over-the-counter tablets every 12 hours
Advil (ibuprofen 200 mg): up to 3 tablets every 6 hours

Choose either ibuprofen or naproxen. Do not take both together.

If you are able to take NSAIDs, use one of the above options on a scheduled basis for the first 3 days following surgery, even if discomfort is mild. Staying ahead of postoperative discomfort often provides better pain control.

If ibuprofen or naproxen alone is inadequate, you may add 1-2 Regular Strength Tylenol (acetaminophen 325 mg each) every 6 hours.

If you are unable to take NSAIDs, 1 Extra Strength Tylenol (acetaminophen 500 mg), or 1-2 Regular Strength Tylenol (325 mg each), every 6 hours is often sufficient when started before the local anesthetic wears off.

Be aware that acetaminophen is also contained in many prescription pain medications and over-the-counter cold and flu products. Do not take additional acetaminophen without considering the total amount you are taking from all medications. If your surgeon has prescribed or recommended a different pain medication regimen, follow those instructions.

Diet & Hydration

Drink plenty of fluids after surgery. Avoid using straws during the early healing period, as suction may disturb the blood clot.

Begin with soft foods that are comfortable to eat. Avoid very hot, hard, crunchy, or sharp foods that may irritate the extraction site. Gradually advance your diet as you feel comfortable, chewing away from the surgical area when possible.

Oral Hygiene

Do not vigorously rinse your mouth on the day of surgery. You may gently brush your teeth, taking care to avoid the extraction site.

Beginning the day after surgery, gently rinse with warm salt water several times each day, especially after eating. Mix approximately one teaspoon of salt into a cup of warm water. Avoid vigorous swishing or spitting.

Continue your normal brushing and flossing routine as you recover, while remaining gentle around the surgical area.

Smoking, Vaping & Alcohol

Avoid smoking, vaping, and other tobacco products during the healing period. These can interfere with healing and increase the risk of complications, including dry socket. The longer you are able to avoid tobacco after surgery, the better.

Avoid alcoholic beverages during the early healing period and while taking medications that should not be combined with alcohol.

Activity

Rest on the day of surgery and avoid strenuous exercise, heavy lifting, and other vigorous activity during the early recovery period. Exercise can increase throbbing, swelling, or bleeding. Gradually return to your normal activities as you feel able.

Dry Socket

A dry socket can occur when the blood clot within an extraction site breaks down or becomes dislodged before healing has progressed sufficiently. Pain from a dry socket typically becomes more noticeable several days after an extraction and may radiate toward the ear or other areas of the face. An unpleasant taste or odor may also occur.

If pain begins to increase after initially improving, becomes severe, or seems unusual for your recovery, please contact our office so that we can evaluate the extraction site.

Multiple Extractions & Immediate Dentures

Recovery after the removal of multiple teeth may be somewhat different from recovery after a single extraction. Swelling, bruising, soreness, and temporary jaw stiffness may be more noticeable, particularly when the bone has been shaped or smoothed in preparation for a denture.

Bruising or discoloration of the face may occasionally develop several days after surgery and usually resolves gradually. Moist heat may be helpful after the first few days if swelling, bruising, or jaw stiffness persists.

A sore throat or discomfort with swallowing can also occur temporarily following multiple extractions.

Immediate Dentures

If an immediate denture was placed at the time of surgery, do not remove it unless you have been instructed to do so by your surgeon or dentist. Some oozing around the edges of the denture is expected during the early healing period.

Your dentist will typically see you soon after surgery to evaluate the denture and make adjustments as needed. Sore spots can develop as swelling and the shape of the tissues change during healing, so follow-up and adjustment of the denture are important.

Once your dentist or surgeon has instructed you that the denture may be removed, follow the instructions you were given for cleaning your mouth and the denture.

When to Call Our Office

Please contact our office if you experience heavy bleeding that does not respond to firm pressure, pain or swelling that is worsening rather than improving, a suspected medication reaction, persistent fever or illness, or any other symptoms that concern you.

Your surgery and recovery are individual. If the instructions provided specifically by your surgeon differ from these general recommendations, please follow your surgeon’s instructions.